Treadmill Training Following Orthopedic Surgery in Lower Limbs of Children With Cerebral Palsy

Abstract

Treadmill training during physical therapy is beneficial for children with CP who undergo orthopedic surgery in the lower limbs.

The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta‐analysis

“…However, there was wide variation in effect size. Supporting studies also found evidence for improved endurance as a result of gait training, with only one case study reporting a decrease in distance covered after intervention . Retention of improved endurance was variable, with improvements both persisting and regressing …”

“…Figure shows the within‐group effect size for each gait outcome reported, and pooled effect of treatment type: physical therapy and strength training; OGT; PBWSTT; treadmill training; gait training enhanced with virtual reality and feedback; and miscellaneous. The miscellaneous studies could not be considered to fit into other groups because of their diverse nature, including studies investigating backward walking, OGT with PBWS, treadmill training with transcranial direct current stimulation, treadmill training with ankle load, and treadmill training after surgery . While interpretation of results of this meta‐analysis should be treated with caution, a tendency towards increased effect size of gait training on walking speed can be observed in gait training groups with gait training enhanced with virtual reality and feedback.…”

“…The use of treadmill training with the addition of transcranial direct current stimulation to stimulate motor learning was also reported to show outlying large effects across all reported outcome measures . In one study, treadmill training was grouped in the miscellaneous category as the intervention was shortly after surgery and therefore outcomes could be partly attributed to natural progression after surgical intervention. Indeed, the large effects noted for walking speed and GMFM dimension E may reflect this.…”

“…The miscellaneous studies could not be considered to fit into other groups because of their diverse nature, including studies investigating backward walking, 31,54 OGT with PBWS, 41 treadmill training with transcranial direct current stimulation, 47 treadmill training with ankle load, 69 and treadmill training after surgery. 48 While interpretation of results of this meta-analysis should be treated with caution, a tendency towards increased effect size of gait training on walking speed can be observed in gait training groups with gait training enhanced with virtual reality and feedback. The effects are less apparent in endurance and GMFM dimension E, where treadmill training shows a tendency towards a larger effect compared with standard physical therapy, PBWSTT and OGT.…”

“…28 Supporting the trend of improved GMFM dimension E, nine studies in levels IV and V showed improvements in gross motor function surpassing the MCID. 36,38,42,48,54,55,59,63,64 One study reported a significant improvement below the MCID, 57 while Crowley et al 37 found no change in score in a single patient case report. Four studies reported lasting positive effects in gross motor function retained in follow-up from 1 month 31,46,47 up to 6 months after intervention.…”